Overview of CPT Code 19220: Breast Biopsy, Needle Core
CPT Code 19220 refers to a needle core biopsy of the breast, a minimally invasive procedure used to obtain tissue samples from a suspicious breast lesion for diagnostic purposes.
When CPT Code 19220 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable breast mass.
- Abnormal findings on a mammogram.
- Suspicious breast ultrasound results.
- Monitoring of known breast lesions.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant a needle core biopsy.
- Lump or mass in the breast.
- Changes in breast shape or size.
- Nipple discharge that is bloody or clear.
- Skin changes over the breast area.
Causes and Risk Factors
Several factors can contribute to the need for a breast biopsy.
- Family history of breast cancer.
- Personal history of breast disease.
- Age over 40.
- Genetic mutations such as BRCA1 or BRCA2.
Diagnostic Tests Before Procedure
Prior to the biopsy, several diagnostic tests may be performed.
- Mammography to identify abnormalities.
- Breast ultrasound to assess the lesion.
- MRI of the breast for detailed imaging.
- Fine needle aspiration for preliminary evaluation.
Procedure Description
The needle core biopsy procedure involves several key steps.
- Patient is positioned comfortably, usually lying on their back.
- Local anesthesia is administered to numb the area.
- A thin, hollow needle is inserted into the breast to obtain tissue samples.
- Multiple samples may be taken to ensure adequate tissue for diagnosis.
- The needle is removed, and pressure is applied to minimize bleeding.
Preparation for the Procedure
Patients should follow specific guidelines before the biopsy.
- Avoid blood thinners for several days prior to the procedure.
- Inform the doctor of any allergies or medications.
- Wear comfortable clothing and avoid wearing deodorant on the day of the procedure.
- Arrange for transportation if sedation is used.
Recovery and Aftercare
Post-procedure care is essential for recovery.
- Rest for the remainder of the day after the procedure.
- Apply ice packs to reduce swelling and discomfort.
- Keep the biopsy site clean and dry.
- Follow up with the doctor for results and further instructions.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Bleeding at the biopsy site.
- Infection at the site.
- Hematoma formation.
- Discomfort or pain in the breast.
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Post-Procedure Follow-Up
Follow-up care is crucial for monitoring recovery.
- Schedule a follow-up appointment within a week to discuss results.
- Monitor for any signs of infection or complications.
- Regular breast examinations as advised by the healthcare provider.
Alternative Treatments
There are non-surgical options available for breast concerns.
- Regular monitoring with imaging.
- Medication for benign breast conditions.
- Lifestyle changes to reduce risk factors.
Home Care Tips
Patients can take simple steps to aid recovery at home.
- Avoid strenuous activities for a few days.
- Take over-the-counter pain relievers as needed.
- Keep the biopsy site clean and dry.
- Monitor for any unusual symptoms and report them to the doctor.
Patient Education & Prevention
Education is key to prevention and early detection.
- Perform regular breast self-exams.
- Schedule routine mammograms as recommended.
- Discuss family history and risk factors with a healthcare provider.
- Maintain a healthy lifestyle to reduce breast cancer risk.
Billing and Coding Information
CPT Code: 19220
Category: Surgical Procedures
Common Modifiers:
- 50 (bilateral procedure)
- LT (left side)
- RT (right side)
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,000 to $3,000.
- Most insurance plans cover the procedure if deemed medically necessary.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
- 19120 - Excision of Breast Lesion
- 19125 - Excision of breast lesion
- 19126 - Breast Biopsy, Needle, Percutaneous
- 19200 - Excision of Breast Lesion
References and Sources
Frequently Asked Questions (FAQs)
Is the needle core biopsy painful?
Most patients experience minimal discomfort due to local anesthesia.
How long does the procedure take?
The biopsy typically takes about 30 minutes.
When will I get my results?
Results are usually available within a week.
Can I drive after the procedure?
If sedation is used, it is best to have someone drive you home.
